Dr. Forrest S. Roth finds that ideal lip lift candidates are patients with a philtrum that has lengthened with age — generally more than 1.5–2 cm from nose to upper lip border — thinning upper lip vermilion, or a lip that does not show adequately at rest. Patients seeking a permanent result rather than ongoing filler maintenance are also strong candidates. Good overall health and realistic expectations about the scar trade-off are required.

Dr. Roth performs the subnasal bullhorn lip lift. An incision is made at the base of the nose following the natural skin crease, shaped to mirror the curvature of the nostrils. A precisely measured strip of skin is removed, and the upper lip is lifted and sutured into its new position. This permanently shortens the philtrum and increases the visible pink of the upper lip without adding volume.

Most patients treated by Dr. Forrest S. Roth are comfortable appearing in public within 1–2 weeks, once bruising and the most pronounced swelling have resolved. Residual swelling continues to fade over 4–6 weeks, during which the final lip shape becomes apparent. A soft diet is recommended for 1–2 weeks to minimize tension on the incision during early healing.

The bullhorn lip lift scar is placed at the base of the nose, following the natural crease at the nose-lip junction. This placement makes the scar difficult to detect when healed — it blends with the existing skin texture changes in that area. Dr. Roth closes the incision meticulously to support optimal scar quality. The scar is pink in the first few months and fades significantly over 6–12 months with proper care including sun protection and silicone treatment.

The lifted upper lip position is visible immediately after surgery, though swelling temporarily distorts the early result. Dr. Forrest S. Roth advises patients that the natural-looking final shape — with fully settled tissues and subsided swelling — is apparent at approximately 4–6 weeks. Because a lip lift repositions the lip structure rather than adding a filler material, the result is permanent and does not diminish over time.

A surgical lip lift and lip fillers address different concerns using different mechanisms. Fillers (such as Juvederm or Restylane) add volume and projection and last 6–12 months before requiring retreatment. A lip lift, as performed by Dr. Forrest S. Roth, permanently shortens the philtrum and increases the visible upper lip by repositioning the lip structure itself — a result fillers cannot replicate. Patients with an elongated philtrum, those seeking a permanent solution, or those who are fatigued by ongoing filler appointments are typically better served by a surgical lift.